Real-world disease burden and planned treatment optimization after MANAGE-PD implementation in Germany: a cross-sectional study.

Q2 Medicine
Martin Südmeyer, David J Pedrosa, Frank Siebecker, Carolin Arlt, Jaakko Kopra, Wolfgang H Jost
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Abstract

Background: In Germany, the approach to treatment optimization for patients with advanced Parkinson's disease (PD) is considered somewhat conservative. The MANAGE-PD tool ( www.managepd.eu ) was developed to help identify patients with advanced PD and to facilitate treatment decision making and appropriate allocation of patients to device-aided therapies (DAT). This prospective, non-interventional study aimed to investigate the real-world disease burden of PD and treatment optimization after MANAGE-PD implementation.

Methods: Adult PD patients (N = 278) visited specialist clinics and neurologist's practices in Germany in 2022. Disease burden was assessed using the Unified PD rating scale (UPDRS parts II-IV), the non-motor symptoms scale (NMSS) and the 8-item Parkinson's disease Questionnaire (PDQ-8). Data on planned treatment changes were collected. Data were analyzed by disease control categories according to the MANAGE-PD tool.

Results: Mean scores for motor and non-motor symptoms, quality of life, and comorbidity burden were worse in patients with lower disease control measured by MANAGE-PD. For 52.8% of patients in Category 2 (inadequately controlled-might benefit from oral optimization), no change in oral treatment was planned. No change in oral treatment and no DAT initiation was planned for 37.9% and 65.0% of patients in Category 3 (inadequately controlled-might benefit from DAT). Patient refusal and needing more time to decide were the most common reasons for not making treatment changes.

Conclusions: This study supports the validity of MANAGE-PD by showing its high association with disease burden and emphasizes the importance of timely provision of necessary information to enable informed decisions about treatment optimization.

德国实施MANAGE-PD后的现实世界疾病负担和计划治疗优化:一项横断面研究
背景:在德国,晚期帕金森病(PD)患者的治疗优化方法被认为有些保守。manager -PD工具(www.managepd.eu)的开发是为了帮助识别晚期PD患者,并促进治疗决策和适当分配患者进行设备辅助治疗(DAT)。这项前瞻性、非干预性研究旨在调查现实世界PD的疾病负担和实施MANAGE-PD后的治疗优化。方法:2022年德国成年PD患者(N = 278)在专科诊所和神经科就诊。采用统一帕金森病评定量表(UPDRS part II-IV)、非运动症状量表(NMSS)和8项帕金森病问卷(PDQ-8)评估疾病负担。收集计划治疗改变的数据。根据MANAGE-PD工具对数据进行疾病控制分类分析。结果:运动和非运动症状、生活质量和合并症负担的平均得分在manager - pd测量的疾病控制较低的患者中更差。52.8%的第2类(控制不充分-可能从口腔优化中受益)患者没有计划改变口服治疗。37.9%和65.0%的第3类患者(控制不充分-可能受益于DAT)没有改变口服治疗,也没有计划开始DAT。患者拒绝和需要更多时间来决定是不改变治疗的最常见原因。结论:本研究通过显示manager - pd与疾病负担的高度相关性,支持了其有效性,并强调了及时提供必要信息的重要性,以便对治疗优化做出明智的决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.40
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0.00%
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14 weeks
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